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• • <br /> Intake & Approval Sheet (FOR PERMIT STAFF ONLY) PERMIT# 47--CLC1` <br /> BUILDING PLANNING <br /> Intake OK by: Date: Intake OK by: Assign To: Date: <br /> Intake Comments: Intake Comments: <br /> ❑ Route to Commercial Building ❑Attach to Project No. <br /> ❑ Route to Residential Building ❑ Route to Historic Reviewer <br /> i <br /> Make this a"W" Permit ❑ OK to Route to Other Departments <br /> Bldg/TI/Addn/Rem Size ❑ Hold in Planning File Drawer <br /> Garage/Accessory Struct.Size Zone <br /> Number of Stories Overlay/Agreement <br /> Basement ❑No ❑Yes , Fin/Unfin Nonresidential Use <br /> Type of Construction Residential Use <br /> Occupancy Group Proposed No.of Dwelling Unit;✓.'/ <br /> Occupancy Load Total No.of Dwelling Units:j <br /> Fire Sprinklers: CI Update Existing El New System El Not Req'd Planning/Landscape Iris�pection Required before Final? ❑Yes ❑No <br /> Reason Sprinklers Required: "In Lieu" Fee:Type: / Amount$ <br /> Fire Alarm: El Update Existing New System El Not Req'd School Impact Fee' Total $ <br /> Reason Fire Alarm Required: Calculated: Credit: <br /> RCW 64.55 MF worksheet req'd for permit? ❑Yes ❑ No ❑Everett Sc ool Dist ❑Mukilteo School Dist <br /> Add'RCW 64.55 docs required prior to final? ❑Yes ❑No Additional tes: <br /> VALUATION CALCULATION: Total$ <br /> Approved By: Date: ° <br /> PUBLIC WORKS <br /> Intake OK by: Date: <br /> Additional Notes: sro.-c_.ts -rz7Rt=Tva>J -To Intake Comments: PW Worksheet Needed if: <br /> csiz-``-t<-1+1-- '-ii,1�...+4o racv,tei..2 970FA6t'- eEISys Dev Eval ❑Traffic Mit Eval <br /> P. ❑Site Work or Drainage Proposed <br /> E❑Backflow Prevention for high hazard: <br /> Approved By: Date: ,==t (Le�7oL/ :(dental,medical,animals,mortuary,hospital, <br /> 14 ;supportive housing) <br /> FIRE DEPARTMENT ❑Route this folder for PW Review at end ---PW Review Worksheet <br /> Separate/Deferred Submittals Required: ❑This project also has a separate concurrent PW Review(Green Folder) <br /> El Fire Sprinklers ❑Fire Alarm ❑Other: AND ❑Create Green Folder ❑Submitted Previously El Deferred <br /> Additional Notes: ❑ This Permit is Approved by Public Works <br /> ❑ See PW Review Worksheet and associated attached items <br /> Fire Dept. Fees: ❑ A Separate PW Permit is Required (Permit#: PW <br /> ❑ Review of As-Built Plans-NO FIRE FEE AND ❑ Is located in this folder <br /> g.Minimal or No Fire Scope-NO FIRE FEE ❑ Is in a Separate Green Folder(join with this folder for permit issuance) <br /> ❑ Review/Inspection Scope-ADD FIRE FEE ❑Will be issued separately(Separate Green Folder,PW issued ahead of Bldg) <br /> Approved By:K ,Ks—©L.,un Date: (_/y,z ❑ Public Works has no scope---PW Not Required <br /> Additional Notes: <br /> ELECTRICAL <br /> Additional Notes: <br /> Approved By: Date: Approved By: Date: <br />